Laparoscopic Treatment of Morgagni Hernia: Report of Three Cases.

We report on three cases of diaphragmatic (Morgagni) hernia with different clinical presentation. It is important to consider the possibility of this rare but potentially very dangerous condition in patients with respiratory problems and pain in the upper abdomen. Before laparoscopy, two different approaches were used in diaphragmatic hernia operations (abdominal and thoracic approach).

First Croatian transvaginal laparoscopically assisted cholecystectomies.

Background/aims: The aim of this study was to determine the feasibility and technical aspects of a new endoluminal surgical procedure: transvaginal laparoscopically assisted endoscopic cholecystectomy.

Methodology: Three female patients underwent transvaginal laparoscopically assisted endoscopic cholecystectomy (aged 40, 61 and 33 years). Pneumoperitoneum was created through a 5mm supraumbilical incision.

[Laparoscopic cholecystectomy in patients with ventriculoperitoneal shunt].

Because of development of laparoscopic surgery and by knowing of its pathophysiological effects on organism, indications for laparoscopic surgery have become more extensive, so this method is today used for therapeutic and diagnostic procedures. Although ventriculoperitoneal shunt is not normally considered a contraindication for laparoscopic surgery, pneumoperitoneum is described as a cause of raised intracranial pressure. Since 1992 when the first laparoscopic cholecystectomy was done at the University Department of Surgery of Sveti Duh Clinical Hospital in Zagreb, three patients with implanted ventriculoperitoneal shunt were managed successfully laparoscopically.

[Effects of pneumoperitoneumon liver function].

Effects of pneumoperitoneum on liver function during laparoscopic procedures in most patients have no clinical relevance. However, with increasing number and types of surgical procedures the laparoscopic operation is now performed in high-risk patients, including patients with pre-existing liver disease. In these patients laparoscopic procedures may lead to serious complication, including acute liver failure.

Cosmetic laparoscopic cholecystectomy.

Background: The cosmetic outcome and recovery time of laparoscopic cholecystectomy has been improved by modifying the operation technique and reducing the number and size of trocars. The next step to improve cosmetic results is moving two trocars below the pubic hairline. We describe our experience in performing cholecystectomy by a combination of European technique using three trocars and moving two ports below the pubic hairline.

[Harmonic scalpel in laparoscopic surgery].

Harmonic scalpel for the tissue cutting and coagulating is a replacement for the high frequency current, which can be connected with diverse complications. The principle is transforming of the electric power into mechanical longitudinal movement of the working part of the instrument, by piezoelectrical transducer situated in the hand piece. Between October 2000 and June 2001, one hundred and three patients were operated using harmonic scalpel.

[Laparoscopic surgery during pregnancy].

Unlabelled: With the development oflaparoscopic surgery, number of contraindications has become less and less. At the beginning of laparoscopic surgery pregnancy was considered an absolute contraindication to laparoscopic surgery, because of unknown influence of CO2-pneumoperitoneum on fetus. Over the past few years, in literature there have been several case reports of successful laparoscopic surgery in pregnancy.

[Education in endoscopic surgery: courses of endoscopic surgery in Split, Croatia].

Education is very important in endoscopic surgery. It can be performed on endoscopic trainers, live animals, and animal organs, using tissue samples or non-natural materials. Practical work and education can also be performed during the assistance or operating under the supervision.

Prophylactic antiemetics for laparoscopic cholecystectomy: droperidol, metoclopramide, and droperidol plus metoclopramide.

Background: Postoperative nausea and vomiting (PONV) is one of the most significant problems in laparoscopic surgery. The antiemetic effects of metoclopramide and droperidol used alone or in combination for prevention of PONV after laparoscopic cholecystectomy (LC) were assessed in this prospective, double blind, placebo controlled randomized study.

Patients And Methods: A series of 140 patients, ASA physical status I or II, were included in the study.

[Catheter placement for peritoneal dialysis using videoendoscopy].

From December 1993 to December 2000 at the Department of Surgery, General Hospital "Sveti Duh", and University, Hospitals Split and Osijek the catheter for peritoneal dialysis was placed in 128 patients, in 137 cases. Videoendoscopic procedure, with the trocar made precisely for that purpose, was used. All surgical procedures, performed in the completely equipped operation room and in general anesthesia, were done without any intraoperative or postoperative complications.

[Helicobacter pylori in biopsy specimen of gastric mucosa: frequency and correlation of rapid urease test with histology].

Between December 1999 and May 2000, general, age and sex distribution of Helicobacter pylori and rapid urease test sensitivity and specificity in correlation with histology were performed on 125 patients after gastroscopy. The average patients' age was 54.98 +/- 15.